Predicting factor of Amsterdam Pediatric Wrist Rules in reducing the need for x-rays in adults with wrist trauma

Abstract

In cases of wrist trauma, although most patients undergo radiography, nearly 50% of them do not have fractures after examining the radiographs. For this reason, these patients should be thoroughly examined when they visit the emergency department so that the number of radiographs and exposure to radiation can be reduced as much as possible. The aim of this study is to the role of Amsterdam Pediatric Wrist Rules in reducing the need for X-rays in adults with wrist trauma. Materials and Methods: This study is a cross-sectional-descriptive-analytical study with a field sampling method. According to the existing guidelines, tomography is requested for all patients, but before going to radiology, the patient is evaluated according to the Amsterdam Pediatric Wrist criteria, and the need or lack of need for the imaging is determined. Then the patient is transferred to radiology and an x-ray is taken. The result of the graph was recorded and finally compared with the result of the Amsterdam Pediatric Wrist. Study variables include age, sex, type of trauma, the result of Amsterdam Pediatric Wrist, and radiological findings. Results: In the present study, 205 patients with complaints of acute wrist trauma and an average age of 41.05 ± 15.90 years were investigated, and 62.4% of them were male. The most common trauma mechanism was related to falling with a frequency of 53.2%. The frequency of fractures in the studied patients after radiography was 32.7% (67 cases) and the most common fracture location was distal radius (73.1%). The sensitivity, specificity, positive predictive value, and negative predictive value of AWR criteria in determining the need for wrist radiography are 71.64%, 96.38%, 90.57%, and 87.50%, respectively.